People who lay or sit in one position for long periods are at risk of developing pressure sores, also known as bedsores or decubitus ulcers. Nursing home residents are more likely to be confined to beds or chairs for long periods of time, and therefore more susceptible to developing pressure sores.
Bedsores or pressure sores occur when pressure on the skin shuts off blood vessels, depriving skin tissue of oxygen and nutrients. Most of us associate this feeling with “pins and needles” or “my leg fell asleep.” For most of us, shifting our weight or body position quickly gets us the feeling back in the affected body part. For nursing home residents, this is not always something they can do on their own. Good or proper nursing care is needed to identify and treat these issues for many nursing home residents. Bad or inattentive care can likewise lead to the development of these dangerous pressure sores.
If proper care is not given, large, deep sores can develop, sometimes exposing the muscle or bone below the skin. Untreated pressure sores can lead to infection, severe pain and death. This is especially true because incontinent residents often develop these open pressure sores in the sacral area of the low back. When a resident cannot control their bowel function, and they have a sacral pressure ulcer, infections such as E. Coli and MRSA often develop with easy entry in to the resident’s blood stream.
Generally, pressure sores can be prevented with proper care. Federal law requires nursing homes must make sure that residents entering the facility do not develop pressure sores; and that residents who have them are given treatment to promote healing and prevent infection. To prevent pressure sores, nursing homes must keep a resident’s skin clean and dry, maintain good nutrition and keep pressure off of vulnerable parts of the body. Changing the resident’s position as often as necessary relieves pressure. Good nursing practice usually dictates “turning and repositioning” the resident at least every two hours. Pressure relieving devices, such as pads and special mattresses, can also help when used timely and properly.
A nursing home must notify the resident’s physician immediately if he or she develops a pressure sore. Lack of communication is the biggest complaint I hear from family members. The nursing home has an obligation to communicate with the resident’s family about changes in their condition, as well as with the resident’s primary care physician. Nursing homes are often slow to notify the family or the physician when a pressure sore is developing in the early stages.
Considering that pressure sores can be so dangerous, even deadly, it is unclear why nursing homes are slow to communicate their existence early in the process. The nursing home resident has a much better chance for the pressure sore to heal if the wound is identified early, and a treatment plan is established. The longer the delay, the worse the wound gets; and the harder it is to treat.
It is unfortunate that good nursing care for pressure sores in a nursing home setting often takes a back seat to a culture of overworked caregivers. These staff members know what to do, but often don’t have enough time to do it due to a chronic culture in the nursing home industry of understaffing.
If you have a loved one in a nursing home, here are some things you can do to protect them from debilitating pressure sores:
1. Inspect their bodies for wounds or blemishes.
2. Ask to see body parts that are covered with bandages.
3. Ask if your loved one needs a turning and repositioning schedule.
4. Ask the nursing home if they maintain logs documenting that the care was provided.
Immediately contact your loved one’s primary care physician if you suspect your loved one has developed a pressure sore to be sure the wound is properly indentified, and that an appropriate care plan is immediately instituted.
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